Traumatic Brain Injury A Roadmap for Accelerating Progress (2022) / Chapter Skim
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2 The Scope and Burden of Traumatic Brain Injury
2 The Scope and Burden of Traumatic Brain Injury
Pages 27-46
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The data and testimonies summarized in this chapter establish TBI as a significant health challenge. FREQUENCY OF TRAUMATIC BRAIN INJURY This section presents epidemiological data on the frequency -- incidence and prevalence -- of TBI.1 1 The incidence of TBI reflects newly diagnosed cases of people with TBI over a specified period, often a year.
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If a patient has multiple injuries and a brain injury is not the most severe of these at the time of admission (e.g., the patient also has an open fracture) , the brain injury may be recorded as a secondary code and thus not picked up by case ascertainment algorithms.
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crashed every day. world's population was living with a medically treated brain injury.
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Civilian Population The Centers for Disease Control and Prevention (CDC) initiated efforts to create a system for national surveillance for TBI by launching the multistate Traumatic Brain Injury Surveillance Program in 1989 (Thurman et al., 1999)
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The leading causes of TBI death included motor vehicle crashes, falls, suicide, and homicide. Suicide became the leading cause of TBI-related death, increasing by 32 percent over this period, with the highest increase among non-Hispanic White people.
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17.5 (17.4–17.7) NOTES: In 2016, the TBI surveillance definition was updated to reflect the transition from the use of the International Classification of Diseases, Ninth Revision (ICD-9)
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A similar decrease of 6 percent was noted for TBI deaths. These estimates are similar to those provided through the Global Burden of Disease study, which reported a 2016 U.S.
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More than 62 percent of children with moderate-to-severe TBI, and even 14 percent of those with mild TBI, experience ongoing disability, requiring specialized medical services and educational support (Rivara et al., 2012)
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. As with other rates of TBI, these may be underestimates, as brain injury often is not reported or detected, particularly in cases of mild injury.
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Females (2017) Unintentional falls 36.2 24.0 35.6 23.9 Motor vehicle crashes 23.3 11.4 22.5 10.8 Unintentionally being stuck by or 2.5 1.2 2.3 0.9 against an object Intentional self-harm 0.7 0.3 0.8 0.3 Assault 8.1 1.7 7.5 1.7 SOURCE: CDC, 2021.
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. The VA's Traumatic Brain Injury Veterans Health Registry captures data about TBIs experienced by Veterans who seek care or benefits from the VA and who served in Operation Enduring Freedom (OEF)
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Of the total lifetime costs, they estimated that 2.4 percent was direct costs, 13.3 percent was for work loss, and 83.3 percent ($631 billion) was for quality of life lost.
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. Pediatric mild TBI or concussion is often overlooked in cost estimation as it is treated primarily in the ambulatory outpatient setting and generally incurs less cost per case relative to moderate or severe TBI, the latter cases entailing emergency diagnostic imaging; procedures; inpatient hospitalization, sometimes in the intensive care setting; and longer-term rehabilitation care, both inpatient and outpatient.
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Furthermore, they found an association between the provision of comfort care and poorer outcomes and higher costs. A scoping literature review investigating economic evaluations of inpatient and outpatient neuropsychological rehabilitation in individuals with acquired brain injury found that the majority documented cost savings (Stolwyk et al., 2021)
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General health care practitioners, including mental health therapists and primary care physicians, often serve people with TBI and their caregivers, but may not have the knowledge of their unique needs and how to assist them.
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I just had to hunt down all the various other doctors I needed to see to take care of my problems. Everyone who has a severe TBI should have some doctor assigned who calls them and who they can call with questions, issues, I think.
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2019. Surveillance report of traumatic brain injury-related emergency department visits, hospitalizations, and deaths -- United States, 2014.
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2007. Using a cost-benefit analysis to estimate outcomes of a clinical treatment guideline: Testing the Brain Trauma Foundation guidelines for the treatment of severe traumatic brain injury.
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2019. Risk of posttraumatic stress disorder and major depression in civilian patients after mild traumatic brain injury: A TRACK-TBI study.
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2019. Estimated life-time savings in the cost of ongoing care following specialist rehabilitation for severe traumatic brain injury in the United Kingdom.
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